| 摘要: |
| ［摘要］ 目的 比较单孔与传统三孔胸/腹腔镜治疗小儿叶外型肺隔离症（EPS）的临床疗效，为优化手术方案提供依据。方法 回顾性分析2017年1月至2025年1月于首都医科大学附属首都儿童医学中心经手术和病理确诊的107例EPS患儿的临床资料，根据患儿接受术式不同分为单孔组（20例）和三孔组（87例）。比较两组基线资料、手术时间、术中出血量、术后住院时间、镇痛药使用率及并发症等指标，分析评估两种术式的安全性和有效性。结果 单孔组手术时间、术后住院时间显著短于三孔组（P<0.05），术后当天口服镇痛药比例显著低于三孔组（P<0.05）。两组均未出现中转开胸、术中输血及严重并发症。三孔组术后1例伤口感染和1例肋骨损伤，单孔组无相关并发症，两组并发症发生率比较差异无统计学意义（P>0.05）。结论 单孔胸/腹腔镜治疗小儿EPS安全有效，较传统三孔法具有手术时间短、术后恢复快、疼痛轻及切口美观等优势，可作为优选术式推广，但需结合术者经验及患儿个体情况综合决策。 |
| 关键词: 肺隔离症 叶外型 儿童 胸腔镜 腹腔镜 单孔 三孔 |
| DOI：10.3969/j.issn.1674-3806.2025.06.06 |
| 分类号:R 726.5 |
| 基金项目:首都儿科研究所及附属儿童医院青年基金项目（编号：QN-2024-10） |
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| A comparative study on efficacy of uni-port and traditional three-port thoracoscopy or laparoscopy in treatment of pediatric extralobar pulmonary sequestration |
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WU Yurui, ZHENG Qipeng, CAO Zhenhua, CHEN Meng, ZHANG Hua, ZHOU Yan, LI Zexi, SU Yun, LIU Jing
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Department of Thoracic and Oncologic Surgery, Capital Center for Children′s Health, Capital Medical University, Beijing 100020, China
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| Abstract: |
| ［Abstract］ Objective To compare the clinical efficacy of uni-port and traditional three-port thoracoscopy or laparoscopy in treating pediatric extralobar pulmonary sequestration(EPS) and to provide evidence for optimizing surgical approaches. Methods A retrospective analysis was conducted on the clinical data of 107 pediatric patients with EPS diagnosed by surgery and pathology in Capital Center for Children′s Health, Capital Medical University from January 2017 to January 2025. The pediatric patients were divided into uni-port group(20 patients) and three-port group(87 patients) according to different surgical procedures received by the pediatric patients. The indicators including baseline data, operation time, intraoperative blood loss, postoperative length of hospital stay, usage rate of analgesics and complications were compared between the two groups to analyze and evaluate the safety and efficacy of the two surgical procedures. Results The operation time and the postoperative length of hospital stay in the uni-port group were significantly shorter than those in the three-port group(P<0.05). On the day after operation, the proportion of the pediatric patients who took oral analgesics in the uni-port group was lower than that in the three-port group(P<0.05). There were no patients converted to thoracotomy in either group, and there were no intraoperative blood transfusions and serious complications. In the three-port group, 1 patient had wound infection and 1 patient had rib injury after operation. In the uni-port group, there were no patients with the corresponding complications. There was no statistically significant difference in the incidence of complications between the two groups(P>0.05). Conclusion Uni-port thoracoscopy or laparoscopy is safe and effective in treatment of pediatric EPS. Compared with the traditional three-port endoscopic surgical procedure, the uni-port endoscopic surgical procedure has the advantages of shorter operation time, faster postoperative recovery, less pain and satisfactory cosmetic outcome of incision. The uni-port endoscopic surgical procedure can be promoted as the preferred surgical procedure, but a comprehensive decision needs to be made in combination with the surgeons′ experience and the individual condition of the pediatric patients. |
| Key words: Pulmonary sequestration Extralobar Children Thoracoscopy Laparoscopy Uni-port Three-port |
